Comparative Assessment between Ibuprofen, Chewing Gum, and Bite Wafers in Pain Control Following First Arch Wire Placement in Orthodontic Patients

Abstract

This study aimed to investigate the effectiveness of using bite wafers and chewing gum in relieving pain after the activation of the first archwire among Saudi orthodontic patients and evaluating them in comparison with ibuprofen use. Furthermore, the study investigated the effect of chewing gum and plastic wafers on the frequency of orthodontic appliance breakage. A total of 105 female patients aged 15-35 years, undergoing maxillary and mandibular fixed appliance treatment were classified randomly into three groups of 35 each. In each group, the patients were given one of the following treatments immediately after the placement of the first archwire, every 8 hours for 1 week as needed: ibuprofen (400 mg), or a viscoelastic bite wafer, or chewing gum. A visual analog scale was given to the patients to record their pain perception following initial archwire placement. In addition, the patients were asked to report any incidence of detached brackets while using the above methods. Data were analyzed using analysis of variance (ANOVA). No statistically significant differences were found in pain perception at any time interval among the three groups. The pain experienced at bedtime and 24 hours after wire placement among different groups in the present study was found to be slightly higher with maximum intensity and the pain perception finding at different time intervals within each pain relief method was statistically significant (p = 0.000, p < 0.05). Furthermore, ANOVA results demonstrate no significant differences in bracket detachment between the groups (p = 0.20, p < 0.05). The use of bite wafers and chewing gum was effective and comparable to ibuprofen use for pain relief following the initial activation of fixed orthodontic appliances among Saudi orthodontic patients. In addition, the study found no clinically or statistically significant differences in bracket detachment between the groups. The nondrug modalities of controlling pain such as chewing gum and/or bite wafers can be used as an alternative to ibuprofen use following the first activation of fixed orthodontic appliances.